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Prostacyclin and analogues for acute ischaemic stroke
1Division of Stroke Medicine, University of Nottingham, City Hospital Campus, Hucknall Road, Nottingham, Nottinghamshire, UK, NG5 1PB. philip.bath@nottingham.ac.uk
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Prostacyclin may improve outcomes for acute ischemic stroke patients, but current research is limited. More randomized trials are needed to determine its effectiveness and impact on survival rates.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Pharmacology
Background:
- Prostacyclin exhibits properties beneficial for platelets, blood vessels, and nerve cells.
- These properties suggest potential for improved outcomes in acute ischemic stroke.
Purpose of the Study:
- To evaluate the efficacy of prostacyclin or its analogues in improving survival rates for individuals experiencing acute ischemic stroke.
Main Methods:
- Systematic review of randomized controlled trials comparing prostacyclin with placebo or control.
- Searches conducted across major databases (Cochrane Stroke Group, Medline, Embase, ISI) and drug company outreach.
- Inclusion criteria focused on trials enrolling patients within one week of stroke onset; trial quality was assessed.
Main Results:
- Analysis included five trials with 191 participants.
- Early mortality (within four weeks) showed a trend favoring prostacyclin (6 deaths vs. 9 placebo deaths; OR 0.63).
- Late mortality data from one trial indicated 50% mortality in both prostacyclin and placebo groups by 10-18 months.
Conclusions:
- The current number of patients studied in randomized trials is insufficient to draw definitive conclusions.
- Further research with larger sample sizes is required to ascertain the effect of prostacyclin on acute stroke survival.